5, with a wide range of 45 to 84 years old. There were equal number of men and women and majority had an ECOG of 0 or 1 (90%). All patients had previously received gemcitabine monotherapy and some had progressed through other additional chemotherapies, including FOLFIRINOX in 8 patients and nab-paclitaxel
combined with other agents in 3 patients. Median number of prior lines of therapy was 2, with a range of 1 to 4. Overall, 18 patients (90%) had received at least two prior treatment regimens. Table 1 Baseline patient characteristics Treatment Patients received treatment for a median of 15 weeks, ranging from Inhibitors,research,lifescience,medical one to six cycles. Eleven patients (55%) were able to receive therapy for at least 4 months. Patients were started on nab-paclitaxel at 100 or 125 mg/m2, with three patients having doses Inhibitors,research,lifescience,medical later medical decreased to 75 or 80 mg/m2. Roughly half the patients were treated on a three week on, one week off cycle, while the other half were treated on a two week on, one week off cycle. Median dose was 100 mg/m2. Majority of patients discontinued treatment due to either progression of disease or decline in functional status (15 patients, 75%). Three
patients (15%) were still on nab-paclitaxel at the time of closing study data collection. Clinical outcome Best response imaging was available in 17 patients (Table 2). Of these patients, while no patient had a complete or partial response, 65% had stable disease at as their best response on imaging. 35% Inhibitors,research,lifescience,medical progressed without any stabilization of disease. There was no discrepancy between response by imaging and clinical impression. Of the 12 patients who had elevated baseline CA 19-9, seven (58%), had a 50% or more decline in levels. The three patients who had uninterrupted CA 19-9 elevation post therapy were all shown Inhibitors,research,lifescience,medical to have progressive disease on first imaging. Table 2 Best response by RECIST criteria in 17 patients with available imaging after
at least one month of therapy Median progression free survival was 3.7 months. In patients who Inhibitors,research,lifescience,medical had a response, median duration of response was 4.7 months. At the end of data collection, 6 out of 19 patients were still living. Median overall survival in the study population first was 5.2 months. Adverse events Adverse events directly attributed to nab-paclitaxel were the cause of treatment discontinuation in only two patients (10%), both being mucositis, in one concurrently with neutropenia. Grade 2 or worse fatigue was seen in four patients while significant dehydration was seen in one patient (grade 3). Only one patient was hospitalized as a result of therapy. Three patients (15%) developed grade 3 or 4 neutropenia with one also developing neutropenic fever. An unexpected adverse event possibly related to nab-paclitaxel was pneumonitis that occurred in five patients. All cases of pneumonitis were grade 1. Discussion Advanced pancreatic cancer has recently witnessed the introduction of the first regimens to improve on gemcitabine therapy in decades.